Pain during labor not needed for effective pushing, doctor says

The common belief that a certain level of pain is necessary during labor to effectively coordinate pushing is an outdated concept, according to Dr. Su Yi-ning, an obstetrician.

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To have a little pain to know how to push harder is actually an outdated concept that is no longer supported by current evidence.

Dr. Su explained on his Facebook page, "Dr. Su's Niggles," that "labor pain relief" and "painless childbirth" are medically the same procedure, most commonly referring to epidural analgesia. While "painless childbirth" is a direct translation, he prefers "labor pain relief" as it more accurately reflects the reality, acknowledging that individual experiences of pain can vary and complete pain elimination cannot be guaranteed.

He clarified that the idea of needing some pain to know how to push is not supported by current evidence. The American College of Obstetricians and Gynecologists (ACOG) guidelines now clearly state that neuraxial analgesia can be used continuously throughout the entire labor process. Studies have shown that maintaining pain relief into the second stage of labor (from full cervical dilation to birth) does not negatively impact the final delivery outcome.

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Painless childbirth, in medicine, is actually the same thing as labor pain relief. The most common is epidural analgesia, just with different Chinese names.

Dr. Su emphasized that modern medicine does not require pain for a successful delivery. While epidural analgesia might slightly prolong labor, potentially adding about ten minutes to the second stage, this is distinct from the necessity of pain for effective pushing and does not directly correlate with the ability to deliver successfully. He also noted that variations in patient experience are due to differences in medication concentration, formulation, administration timing, and the anesthesiologist's expertise.

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Neuraxial analgesia can be used continuously throughout the entire labor process.